Roseville Endoscopy Center, LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

030000786 Issued in CA

Legal business name

ROSEVILLE ENDOSCOPY CENTER, LLC

Practice address

4 Medical Plaza Dr
Suite #210
Roseville, CA 95661-2815

Phone

(916) 773-8780

Fax

(916) 773-8793

NPI assigned

May 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Ross

Title

Administrator

Phone

(916) 781-5263

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Sutter Roseville Endoscopy CenterCCN 05C0001712

Medicare certification status

ActiveFrom the Provider of Services file

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Capitol Gastroenterology Consultants Medical Group, Inc.

  • Gastroenterology Physician
  • Roseville, CA
  • NPI 1013056779

  Member Of

  NPD member
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Los Banos, CA
  • NPI 1366896300

  Member Of

  NPD member
• Sutter Valley Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Stockton, CA
  • NPI 1467825844

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1376592014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PLAZA DR",
            "address_2": "SUITE #210",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PLAZA DR",
            "address_2": "SUITE #210",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612815",
            "telephone_number": "916-773-8780",
            "fax_number": "916-773-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-781-5263",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "CA",
            "license": "030000786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseville Center for Interventional Psychiatry, Inc
• Roseville City Elementary
• Roseville Dermatology Inc.
• Roseville Diagnostic Hearing Center, Inc.
• Roseville Diagnostic Hearing Center, LLC
• Roseville Family Urgent Care Inc
• Roseville Foot and Ankle PC
• Roseville Health & Wellness Center
• Roseville Heritage Partners, LP
• Roseville Joint Union High School District

• Endoscopy Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Endoscopy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.